The Healthcare Conundrum

Posted On 03 Feb 2017 / 0 Comment

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As the Republicans begin to disassemble the Affordable Care Act (ACA) also known as Obamacare detractors are cheering while those on the left are screaming bloody murder. But there is a problem with the arguments on both sides. The ACA has done nothing about the high cost of healthcare.

This is the mirage of what the ACA is all about that has been masqueraded since it was introduced to the public in 2009 and put into law in 2010. The ACA does nothing to address the cost of healthcare and prescription medications.

That’s right, we are paying the same price for the goods and services before the ACA was forced upon the American citizens now seven years ago. What the Affordable Care Act does is force all citizens to carry health insurance. If they don’t want insurance they have to pay an annual tax for not having approved insurance.

This is another way for the federal government to get into the private citizen’s pocket as well as private businesses’. All the ACA does is require you to spend money on an insurance policy whether you want one or not. It does not impact what drug companies, hospitals or doctors charge for their goods and services. And that’s the problem.

The healthcare industry is looked at as one of those few, if not only professions that if there is any question of the service or price it is considered sacrilegious. And there is no proper way to challenge its pricing structure. Any other profession from dining to auto repair and real estate all prices are negotiable. Not medical services or prescriptions, although the latter is finding itself becoming more negotiable because of the competition between big retail chain pharmacies who are trying to optimize their business by offering lower priced prescriptions – not to aid the patient but because there is a belief once you’re in their store they can make you buy other items even if you have your prescriptions delivered or use a drive-thru. Once they get your email address you will be inundated by offers and sales you might and probably don’t care about. I guess that’s one of the costs of affordable prescriptions in this country.

Doctors, hospitals and other healthcare services are never questioned or called out on what they charge for their goods and services. Whereas, if I need new brakes for my car I can call and compare prices. And while I realize this is comparing apples to oranges, the fact the healthcare and drug industry can set their own prices without consequence doesn’t seem to bother anyone. And how do they do it?

They hold our lives hostage.

Yes, you read that last line correctly. Doctors, their nurses and others in the business of medicine pretty much strong-arm everyone when it comes to surgery, treatment and prescription drugs. We are basically told if we don’t agree to a procedure; take their pills and so on we will die a miserable death. Sometimes it is warranted, but as recently as four months ago it was released that women are now getting way too many mammograms – or needless ones. And Lord knows women and the general populace has had breast cancer for better or worse thrown in their face. I realize if you’ve had a loved one that has succumbed to cancer you are more voracious about it and with just cause. Yet all these years later they’ve really gotten nowhere to eliminate cancer. Oh sure, cancer survival has increased many fold, but why we get it no one still knows. There are scapegoats like smoking, sun exposure, pollution and others but not everyone exposed to any of these have contracted cancer. Instead, the patient is put through grueling treatments and surgeries that cause most unless they are either wealthy or have top-notch private health insurance to go deeply in debt or be forced into bankruptcy. Modern medicine will argue, “at least you’re still alive”. Yet they don’t realize that debt is one of the leading causes of suicide or mental instability. And medical bills are one of the leading causes of bankruptcy filings.

The pills we are prescribed all treat the symptoms of what is wrong with us. They don’t fix or attack what is wrong. When being written a prescription one time I told my doctor that the medicine he was prescribing only addressed the symptoms of the problem and how do I fix what’s wrong. He had no real answer for me and told me to just take the meds. He’s no longer my doctor.

As I’ve gotten older I’ve had to visit specialists because, “well, you’re at that age”. I went to see a heart doctor that I was referred to. I was immediately put off when I arrived not only by the fact as soon as I signed in they asked for my insurance card, but the fact that the paperwork they had me fill out was on a clipboard and with a pen from a pharmaceutical that had been taken off the market by the FDA.

When the doctor entered the room as I waited and waited before he even introduced me he handed me three prescriptions. “You need to be on this stuff,” he said. I asked why. “You just need to be,” he answered angrily. I then said, “why should I believe you when you had me fill out paperwork with a pen and on a clipboard that advertised a medication that the FDA pulled off the market?” I could see the anger in his eyes and our consult was contentious. That was the one and only time I saw this heart “specialist”. Months later I read in the newspaper where he was put on leave from his practice because he got into a verbal then physical confrontation with a fellow doctor. I called that one right.

I was given another doctor who was more stable but after meeting me he wanted to put me on all sorts of cholesterol lowering medications. When I asked why he told me just because and at may age. I already knew my cholesterol numbers and they were non-existent. He told me to come back in three months for a lipid test.

I took the prescription and stuck it in my glove box and never looked at it again. I came in for my lipid test to have my cholesterol tested. The test was quick and painless. A few minutes later the aid that gave me the test said, “ keep using those meds, you’re bad cholesterol was really low.” I said to the guy that gave me the test, “can I be honest with you?”

He inched over and I told him I never filled the prescription. He got this shocked look on his face. “Don’t bother, throw it away. You don’t need it.”

And how do we choose our “specialists”? Referral. Many doctors won’t see you unless you get a referral. It’s like a high school clique. There are groups of doctors that refer patients to each other in what in layman’s terms, to line each other’s pockets. If you’ve been told about a specialist that’s not in their clique they will try to send you elsewhere. If you are insistent with them more often than not they’ll do it but they will be visibly unhappy.

And if you ever have to have kidney dialysis the doctors have hit the jackpot. You will forever be tied to going to a series of doctors on a regular business. After two years of dialysis the patient is forced to get Medicare to help pay for treatments. A traditional dialysis patient has to be in clinic a minimum three days a week. Besides dialysis more often than not a patient will be given a series of prescriptions they have to take because of kidney failure. And this can get expensive without private insurance or a Medicare supplement. To give you an example of some of the medicine subscribed to a dialysis patient is Sensipar that treats secondary hyperparathyroidism. Almost everyone at a clinic has a subscription. Without insurance a one-month supply costs a little over $1,700 a month. With private insurance or a supplemental Medicare policy the price is lowered to $30 a month. If you go to the Sensipar website you can download a voucher of card to lower the prescription to $5 a month if you have private insurance or a private Medicare supplemental policy. Why can’t they sell it for $5 a month without making patients jump through so many hoops?

And why do they get to set such a high price? Most drug companies receive grants and government subsidies to aid in all the research for our prescription drugs. They create the pills for pennies on the dollar and expect us to adsorb whatever cost they decide to charge because “it will help save our life”. They don’t care about my life or yours all they care about is the bottom line. Just look at the Epi-Pen controversy that took place in the fall when the maker of the drug decided to increase the price of the lifesaving injectible for asthma by 500 percent. And less we forget last year when the maker of an Aids drug did the same thing and quite literally laughed at the patients and media about it offering no explanation or apologies.

The American healthcare system has been around for a few hundred years now. After all this time is there a way to hold them accountable for how much we are charged? Healthcare is great but unlike sports and the arts they’ve become big business and unlike the other two people are dying to be seen – both figuratively and literally. With a never-ending stream of customers is there something that can be done to make actually affordable for everyone? Actually, yes there is.

What is the biggest financial burden for every doctor or nurse? Education. Here is how you begin to fix our healthcare system. Provide free education to potential doctors. Many young doctors find themselves from tens of thousands to hundreds of thousands in debt before they see their first patient because of the cost of education. The only doctor or specialists that can be left off this are plastic surgeons or vanity doctors – you know the ones who specialize in strictly aesthetic augmentations like face lifts and breast augmentations, which are purely voluntarily. However there are plastic surgeons that would be approved. Many don’t realize an amputee or a burn victim will see a plastic surgeon to help heal their wounds. And some nose jobs and facial reconstructions are not aesthetic.

After receiving their education and training they will work as a resident at a healthcare facility one perhaps our government either state or federal government will build. At this point they will be required to work for roughly seven years (this can be slightly altered). These facilities will provide affordable healthcare, surgery and checkups and in some cases free depending on a patient’s financial status. No matter what the patient will never be turned down or put off for proper care. The doctor or specialist will get paid a fair salary: nothing like many are making today, but let us not forget they did not go in debt to become a healthcare provider.

After this five or seven year stint at this facility then the may leave for private practice or join a larger private medical group. During their time interning (for lack of a better word), they will probably go the extra mile because their entire time will be used attract private medical groups or private healthcare providers that would want to take them in and then they can make a salary today’s doctors are more accustomed. Their entire time would be one big audition. And just like the marketplace, the better product you can offer the more your worth. It’s quite simple.

The American healthcare system is a conundrum and no one seems to care except those that can’t get help or are denied. It’s about time the industry was held accountable for the limited access many have and for what it costs the consumer. And it’s time they were held accountable. After all it’s a matter of life and death – ours.